EPIDEMIOLOGY  
 
 
049
TUBERCULOSIS IN A RURAL POPULATION OF SOUTH INDIA: REPORT ON FIVE SURVEYS
AK Chakraborty, Hardan Singh, K Srikantan, KR Rangaswamy, MS Krishnamurthy & JA Steaphen: Indian J TB 1982, 29, 153-67.

The trend of tuberculosis in a sample of 22 villages of Bangalore district observed over a period of about 16 years (1961-77) is reported. Distribution of tuberculin indurations did not show a clear cut demarcation between infected and non-infected. The method adopted to demarcate the cut off point has been described herewith: Distribution of tuberculin induration size of 0-14 years was attempted and extrapolated to higher age groups. Even in these younger age groups the antimodes were not clearly defined, so the antimode was arrived by fitting two normal curves as two likely modes.

The choice of demarcation level, therefore, is somewhat arbitrarily made on the basis of the distributions and these varied from survey to survey; between 10 mm at survey I and 16 mm at survey V. The actual and standardized infection rates showed more or less declining trend in 0-4 years, 5-9 years and 10-14 years age groups. The prevalence of cases was not significantly different from survey to survey (varying from 3.96 to 4.92 per thousand from first to fifth survey). However, there was a shift in the mean age of cases, and better survival rate of cases diagnosed at later surveys.

KEY WORDS: TREND, CASE, INFECTION, PREVALENCE, TUBERCULIN READING METHOD, LONGITUDINAL SURVEY.
 

 
  SOCIOLOGY  
 
 
072
ILLNESS PERCEPTION AND MEDICAL RELIEF IN RURAL COMMUNITIES
Radha Narayan, Susy Thomas, N Srikantaramu & K Srikantan: Indian J TB 1982, 29, 98-103.

Illness is mostly a subjective awareness of an individual, the relief of which may be sought within or outside medical or health facilities. Perception of illness vary from people to people depending upon cultural, ethnic and socio-economic differences. Perception of symptoms by persons suffering from tuberculosis is very high yet only half of them approach modern medical facility for alleviation of their suffering. A survey was carried out in rural area of Hoskote taluk, Bangalore district to determine perceived morbidity and accessible medical relief in 1433 households belonging to 18 villages; of them, 1393 (97%) were successfully interviewed. Selected households belonged to three types of villages i.e., those being within 3 kms of a i)PHC, ii)taluk headquarters hospital and non- Governmental health centre.

Of the 9286 individual belonging to 1393 households satisfactorily interviewed regarding health, 1201 (12.9%) were found to be ill at some point of time during the reference period of one month. No differences were observed in the perception of morbidity or in the health seeking behaviour in the three groups of villages. Persons with symptoms/disease accounted for 88.8% of the total sickness, 3.4% for injuries and 9.3% for disabilities, while action taking was 61.6%, 90% and 13.5% respectively. Age sex distribution showed no difference in illness occurrence. Sputum was collected from 147 chest symptomatics and seven were found to be sputum positive. Government health facilities were utilized by 37.6% of the sick persons, private doctors by 36.4%, nature medicine by 10.6% and home remedies by only 9.9%. In conclusion, the services at the government health facilities were acceptable and were utilized if accessible. Prompt and adequate relief for injuries and acute indispositions ensures confidence of the people and better utilization.

KEY WORDS: ILLNESS PERCEPTION, RURAL COMMUNITY, MEDICAL RELIEF, HEALTHSERVICES, UTILIZATION.
 

 
  OPERATIONS RESEARCH  
 
A : Problem Definition
 
085
FEASIBILITY OF INVOLVEMENT OF THE MULTIPURPOSE WORKERS IN CASE-FINDING IN DISTRICT TUBERCULOSIS PROGRAMME
KS Aneja, NK Menon-, AK Chakraborty, K Srikantan & M Manjunath: Indian J TB, 1980, 27, 158-66.

At present, Case-finding activity of tuberculosis through the self reporting chest symptomatics attending Peripheral Health Institutions, is at a low ebb. With the introduction of Multi Purpose Workers (MPW) scheme, a machinery has emerged through which this activity could be augmented. An operational study was therefore undertaken in five Primary Health Centres (PHCs) of Chittoor district, Andhra Pradesh in June 1978.

The study has revealed that if the MPWs collect sputum smears from the symptomatics of the age group of 20 years and above during their routine visits to each household of the specified population allotted to them and despatch the smears to the PHC for examination, there is a possibility of augmenting the existing Case-finding activity by 4 5 times. An intensive training of 2 3 days for this purpose seems adequate. The average work load for a MPW would be preparation of one smear a day initially for a couple of months and thereafter as a routine one smear a week. In an average PHC, the work load for the microscopist would be to examine 10 to 12 slides a day initially, the load will then progressively decline and subsequently as a routine it will not be more than 3 4 slides a day. An additional microscopist would probably be needed at PHC laboratory for examination of sputum smears as well as to assist the existing microscopist who at present is primarily engaged in malaria work. Meticulous supervision and regular flow of supplies and equipment is however a 'must' for the success of the scheme.

KEY WORDS: HEALTH WORKER, CASE-FINDING, CONTROL PROGRAMME, PRIMARY HEALTH CARE.
 
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